Adrenal vein sampling (AVS) is the gold standard for localization of aldosterone producing adenoma. The anatomy of the right adrenal vein makes this procedure technically demanding and it may yield no clinical information if the adrenal veins are not adequately cannulated. Having frequently observed the technical failure of AVS, we undertook a review of 220 procedures in British Columbia, Canada.
Subjects were retrospectively identified through the laboratory information system. The following were collected: demographics, screening aldosterone concentration and renin activity/mass, results of dynamic function tests, AVS aldosterone and cortisol results. Standard calculations were performed on AVS data and site-specific success rates were compared. The effect of adrenocorticotropin hormone (ACTH) stimulation on the selectivity index (SI) and lateralization index (LI) were explored.
The overall technical success-rate of AVS procedures was only 44% in procedures where no ACTH-stimulation was used (n=200) but this rose significantly (p
In a study performed at a Stockholm clinic for young people with drug abuse problems, where urine adulteration was suspected to be fairly frequent, a total of 594 patient specimens were subjected to Adultacheck test strip screening for nitrite, glutaraldehyde, pH, and creatinine. Creatinine measurement was also performed at the laboratory, together with drug screening using EMIT reagents, and a subsample was spiked with phencyclidine to verify EMIT test function. The frequency of dilute urine (creatinine
Although AIDS is often thought of as a "big-city" disease, it is also becoming a serious health care issue for doctors and other health care workers in "small-city" Canada. Kingston, Ont., is one of those small cities, and of the facilities trying to come to grips with a disease about which much remains to be learned. In this article, Drs. Peter Ford and David Robertson outline their hospital's estimate of the cost, in manpower and money, of dealing with the AIDS crisis. The final estimate: roughly $700,000. Although most of the cost will involve one-time capital spending, they point out that there will likely be ongoing labour-related costs because of the special programs and increased manpower needed to deal with AIDS patients. Clearly, AIDS is no longer a big-city disease.
Occurrence of molds and actinomycetes in the breathing zone of farmers during the handling of hay, straw, or grain was studied with the use of an Andersen sampler on 35 farms in Finland. On 24 farms there was a person with recently diagnosed farmer's lung disease, and on 11 farms people were free of the disease. The total spore concentration and the concentrations of the spores of Thermoactinomyces (T) vulgaris, Micropolyspora (M) faeni, and Aspergillus (A) umbrosus were statistically significantly higher on the farms of patients with farmer's lung than on the disease-free farms. The mean proportions of the spores of thermotolerant and thermophilic microbes were greater on the farms of farmer's lung patients than on the reference farms. T vulgaris was the predominant actinomycete species. Both T vulgaris and A umbrosus were found on all farms of farmer's lung patients, but M faeni on only about half of such farms. The findings match the results of previous microbiological analyses of Finnish moldy hay and serological analyses of Finnish farmer's lung patients. It seems that T vulgaris, not M faeni, may be the main causative agent of farmer's lung in Finland. The possible etiologic role of A umbrosus requires further investigation. Because the farmers often failed to identify the moldiness of the plant material in contrast to researchers, it might be possible, through training, to improve farmers' ability to identify moldiness.
Type 2 diabetes (T2D) and impaired glucose tolerance (IGT), historically extremely rare in children, is becoming prevalent among First Nations children. In Canada, many of these children live in remote villages accessible only by float plane. Because T2D has many long-term health implications, prevention and early identification are critical.
We developed a process for sending a fully equipped endocrinology team to a remote community to screen the children for T2D and IGT. Float plane (sea plane) travel has several unexpected limitations for a medical research team. These include having to travel in good visibility (visual flight rules), limited payload capacity, and restriction against transporting dry ice. The benefits include avoiding the usual security restrictions.
We developed and tested a custom-built insulation jacket and system of backup battery packs for the countertop -25 degrees C freezer (in lieu of dry ice) to transport frozen blood samples from the village to our hospital's laboratory. We also ensured that the five-member research team, its equipment, and the consumable supplies stayed within the maximum takeoff weight of the airplane and met center-of-gravity criteria to ensure a safe flight.
Using the insulated freezer, sample integrity was maintained throughout the flight, and a safe weight-and-balance trip was achieved for the team and supplies. The team obtained complete T2D screening data on 88% of children in the remote community.
Members of racially and ethnically diverse groups have been persistently underrepresented in biomedical research in general, possibly due to mistrust with the medical and research community. This article describes the perceptions, understandings, and expectations of Alaska Native people about research involving the collection and storage of biological specimens.
Stratified focus groups.
Twenty-nine focus groups with Alaska Native people (n = 178) were held in 14 locations using a semi-structured moderator guide. ATLAS.ti was used for thematic analysis through iterative readings and coding. Alaska Native peoples' perceptions, understandings, and expectations of researcher beneficence, informed consent processes, and provision of research findings were elicited.
Alaska Native people desired extensive disclosure of information beyond that typically provided in consent and results dissemination processes. Information germane to the motivation and intent of researchers and specifics of specimen storage and destruction were specifically requested. A clear and extensive process of informed consent and continued improvements in sharing results may enhance the transparency of research intent, conduct, and use of obtained results among Alaska Native people. Meeting expectations may improve relationships between researchers and the Alaska Native population which could result in increased research participation. Our findings offer a guide for researchers and communities when planning and implementing research with biological specimens.
Cites: Scand J Public Health. 2004;32(3):224-915204184
House dust mites are the most important indoor allergens in our region. During recent years more dwellings have become infested, most likely as a result of increased indoor humidity due to reduced ventilation. Among Danish adults, 14% have developed IgE against mites. The allergens are stable and can remain for years. Keeping the humidity low ( 55 degrees C mites are killed and allergens removed. In addition mattress covers seem to be useful, although guidelines for quality assessment are lacking. Reduction in mite exposure will reduce development of allergy in all age groups especially in the newborn period. Immunotherapy can be offered in rhinitis and moderate asthma when sufficient allergen reduction cannot be accomplished.
More than 80,000 blood samples are annually transported to the Lutsk diagnostic center for assessment of antibodies to HIV. A polystyrol container for 50 vials is used for transportation of the blood samples for these purpose. The advantages of this way of transportation are discussed.